The present invention relates generally to medical catheters and relates more particularly to medical catheters of the type having an internal bolster disposed at one end of said medical catheter for retaining said end of said medical catheter within a patient.
Certain patients are unable to take food and/or medications transorally due to an inability to swallow. Such an inability to swallow may be due to a variety of reasons, such as esophageal cancer, neurological impairment and the like. Although the intravenous administration of food and/or medications to such patients may be a viable short-term approach, it is not well-suited for the long-term. Accordingly, the most common approach to the long-term feeding of such patients involves gastrostomy, i.e., the creation of a feeding tract or stoma between the stomach and the upper abdominal wall. (A less common approach involves jejunostomy, i.e., the creating of a feeding tract or stoma leading into the patient's jejunum.) Feeding is then typically performed by administering food through a catheter or feeding tube that has been inserted into the feeding tract, with one end of the feeding tube extending into the stomach and being retained therein by an internal anchor or bolster and the other end of the feeding tube extending through the abdominal wall and terminating outside of the patient.
Although gastrostomies were first performed surgically, most gastrostomies are now performed using percutaneous endoscopy and result in the implantation in the patient of a feeding tube having a resilient dome-shaped member disposed at the internal end thereof to serve as an internal bolster (said feeding tube/internal bolster assembly also commonly referred to as a percutaneous endoscopic gastrostomy (PEG) device). Two of the more common percutaneous endoscopic techniques for implanting a PEG device in a patient are “the push method” (also known as “the Sacks-Vine method”) and “the pull method” (also known as “the Gauderer-Ponsky method”). Information regarding the foregoing two methods may be found in the following patents, all of which are incorporated herein by reference: U.S. Pat. No. 5,391,159, inventors Hirsch et al., which issued Feb. 21, 1995; U.S. Pat. No. 5,167,627, inventors Clegg et al., which issued Dec. 1, 1992; U.S. Pat. No. 5,112,310, inventor Grobe, which issued May 12, 1992; U.S. Pat. No. 4,900,306, inventors Quinn et al., which issued Feb. 13, 1990; and U.S. Pat. No. 4,861,334, inventor Nawaz, which issued Aug. 29, 1989.
Although PEG devices of the type described above work well for their intended purpose, many active patients find the nearly one foot length of tubing that extends externally to be unwieldy, difficult to conceal and susceptible to being inadvertently pulled on. As can readily be appreciated, these conditions are potential sources of physical and/or psychological trauma to the patient. In addition, PEG devices of the type described above have a tendency to become worn after long periods of use. Consequently, a variety of replacement tube assemblies (also referred to in the art as replacement PEG devices) have been designed for implantation within the stoma tract following the removal of an initially-implanted PEG device. Examples of such devices are disclosed in U.S. Pat. No. 4,944,732, inventor Russo, which issued Jul. 31, 1990, and U.S. Pat. No. 5,836,924, inventors Kelliher et al., which issued Nov. 17, 1998, both of which are incorporated herein by reference.
Other patents and patent applications of interest include U.S. Pat. No. 4,863,438, inventors Gauderer et al., which issued Sep. 5, 1989; U.S. Pat. No. 5,720,734, inventors Copenhaver et al., which issued Feb. 24, 1998; U.S. Pat. No. 6,042,577, inventors Chu et al., which issued Mar. 28, 2000; and International Publication Number WO 03/092780A2, published Nov. 13, 2003, all of which are incorporated herein by reference.